Atypical t(15;17)(q13;q12) in a patient with all-trans retinoic acid refractory secondary acute promyelocytic leukemia: a case report and review of the literature.

Sobha Kurian, Thomas F Hogan, Ona C Bleigh, Yvonne G Dowdy, Taha Merghoub, Pier Paolo Pandolfi, Sharon L Wenger

Journal: Cancer genetics and cytogenetics 2003;138(2):143-8

PMID: 12505260

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Abstract

A 69-year-old woman developed microgranular acute promyelocytic leukemia (APL-M3) 10 months after receiving adjuvant cyclophosphamide, doxorubicin, and paclitaxel for breast cancer. Replicate bone marrow aspirate karyotypes contained a translocation between the long arms of chromosomes 15 and 17, but not at breakpoints typical for APL. Fluorescence in situ hybridization paints and RARalpha/PML cosmid probes verified that the breakpoints on chromosomes 15 and 17 were proximal to both the PML and RARalpha genes; t(15;17)(q13;12). Although the patient received induction chemotherapy and a several month trial of all-trans retinoic acid (ATRA), there was no clinical improvement or hematological remission. We suspect that this patient developed postchemotherapy secondary APL with an atypical t(15;17), which rendered her leukemic cells unresponsive to ATRA therapy.

Address: Department of Medicine, West Virginia University, Morgantown, WV 26506, USA.

DOI: 10.1016/s0165-4608(02)00591-5

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MeSH Terms: Aged, Bone Marrow, Breast Neoplasms, Chromosome Breakage, Chromosomes, Human, Pair 15, Chromosomes, Human, Pair 17, Drug Resistance, Neoplasm, Female, Humans, In Situ Hybridization, Fluorescence, Leukemia, Promyelocytic, Acute, Receptors, Retinoic Acid, Retinoic Acid Receptor alpha, Translocation, Genetic, Tretinoin